Occupational Therapy Doctorate vs. Master's Degree: What's the Difference?
November 05, 2021
A master's degree is sufficient to practice occupational therapy—for now. Even if that doesn't change, there are persuasive reasons to earn a doctorate in this field.
Most of us don't think twice about how we catch a ball with two hands, let alone blink or swallow. That automation relies on a constant interplay between our musculoskeletal and neurological systems. We describe these actions as intuitive.
But what happens when our systems can't coordinate smoothly? When illness, injury, disability, developmental delays, or mental health challenges interfere, people of all ages can lose autonomy in their daily lives—and self-esteem. That's where occupational therapy comes in.
Occupational therapists tailor therapeutic programs to help patients accomplish daily tasks independently and efficiently. Occupational therapy draws on a broad array of healthcare disciplines: anatomy, neurology, gerontology, pediatrics, biomechanics, and psychology, to name a few.
The satisfaction of helping others drives occupational therapists. However, they also enjoy a booming hiring market, long-term career flexibility, and comfortable compensation. It's no wonder US News & World Report includes it in its Top 10 Best Healthcare Jobs, and ranks it #19 of 100 Best Jobs overall.
If you like the idea of harnessing thousands of strategies to give patients independence and free up meaningful time in their days, a career in occupational therapy may suit you.
To get started as an occupational therapist, you'll need to decide between the two educational paths to entry recognized in the field: a Masters in Occupational Therapy and an Occupational Therapy Doctorate (OTD). In our guide to an occupational therapy doctorate vs. masters, we cover:
- What degree do you need to practice occupational therapy?
- Masters in occupational therapy
- Doctorate of occupational therapy
- Will a doctorate someday be required to practice occupational therapy?
- Occupational therapy masters vs. doctorate: does it matter which I get?
What degree do you need to practice occupational therapy?
An entry-level position in occupational therapy requires a master's degree at a minimum, either the Master of Occupational Therapy (MOT) or a Master of Science in Occupational Therapy (MSOT), both of which require about 2.5 years of coursework.
Some aspiring occupational therapists (OTs) choose an alternative to the masters, the entry-level Doctor of Occupational Therapy (entry-level OTD). Like the masters, this doctorate attracts students without professional experience in occupational therapy, covers the same academic foundation, and prepares students to take the National Board for Certification in Occupational Therapy Test (the NBCOT certification exam).
The entry-level OTD can also include additional fieldwork and coursework, allowing students without professional experience to explore areas of specialization before entering the workforce.
The American Occupational Therapy Association (AOTA) is the professional organization in charge of both the NBCOT exam and educational program accreditation, via the Accreditation Council for Occupational Therapy Education (ACOTE). As of 2021, ACOTE has recommended, but stopped short of mandating, that entry-level master's programs convert to entry-level doctoral programs, leading some to speculate that a mandate may come. For the time being, however, the entry-level doctorate remains optional.
Master's in occupational therapy
A master's degree in occupational therapy is the minimum requirement for entry in the field for autonomous practitioners (you can become an OT assistant with a bachelor's degree, but you can't practice on your own). Most states require the degree for licensure. It also prepares graduates to pass the National Board Certification in Occupational Therapy (NBCOT . When graduates combine their degree with the national board credentials and state licensure, they have everything they need to practice.
Most MOT programs require the following of applicants:
- Bachelor's degree: Aspiring occupational therapists must have a bachelor's degree, typically earned in related fields such as biology, kinesiology, psychology,s and sociology.
- Prerequisite courses: If you earned your bachelor's in an unrelated field, you will likely need to take prerequisite courses before applying. Common prerequisite areas of study include statistics, anatomy, and psychology.
- GPA: Some programs impose a minimum GPA requirement to ensure applicants can successfully undertake graduate-level coursework.
- GRE scores: Most programs require applicants to take the Graduate Record Exam (GRE). Check with your targeted programs to see if they require a minimum score.
- Volunteer hours: Also called observational or shadowing hours, most programs require a moderate number (40) of hours in an occupational therapy professional setting. Ambitious applicants often rack up more than 100 hours to stand out amid the competition.
MOT programs (and entry-level doctoral programs) craft foundational curricula to give students a broad mastery of the field. To graduate as well-rounded generalists, Masters of Occupational Therapy programs typically offer the following areas of coursework:
- Adult rehabilitation
- Anatomy and physiology
- Assessing occupational performance
- Assistive technology
- Behavior and the brain
- Evidence-based practice
- Foundations of occupational therapy
- Movement analysis
- Occupational wellness
- Occupations across the lifespan
- Patient care
In addition to coursework, students in master's programs for OT undertake two levels of fieldwork.
The first level of fieldwork is a practicum referred to as Level I. It focuses on observation: students shadow licensed OTs in multiple settings. Only direct supervision permits their limited involvement in patient care.
Level II fieldwork is akin to a hands-on internship. Students provide occupational therapy services directly to patients under the supervision of a licensed therapist. Per the AOTA, all accredited programs must require at least 24 weeks of direct, supervised fieldwork.
If you're interested in becoming an OT, you're likely motivated to help others improve their quality of life. When that sense of purpose meets a dynamic and growing marketplace, you may find your quality of life improves as well. Demand for OT professionals is expected to increase by 24 percent between 2016 and 2026. Licensed occupational therapists earn a median salary of $84,270 annually, or $40 per hour. Overtime rates may almost double the hourly rate.
In addition to the array of specializations within the field, occupational therapists enjoy a flexible range of employment possibilities across industries. They leverage their master's degrees as recruiters, rehab intake specialists, health and wellness coaches, and tech usability experts.
Doctor of occupational therapy
There are three main types of doctoral degrees in occupational therapy: the entry-level doctorate; the post-professional doctorate; and the research-focused PhD.
- Entry-level doctorates: As mentioned earlier, this path is geared towards students who have a bachelor's in a related field but no direct experience in occupational therapy. It secures the same basic qualifications as the master's degree, albeit with a greater investment of time (four years or more) and money. It requires more fieldwork than the master's and can offer an early path to specialization or academic research.
- Post-professional doctorates: After practicing with a master's degree, some occupational therapists pursue a post-professional doctoral degree (OTD). Post-professional OTD students are already licensed and typically have several years of professional experience. Expect to spend at least three years earning a post-professional doctorate, which typically requires 35 to 100+ credit hours of work.
- PhD in Occupational Therapy: In contrast to the clinical focus of the OTD, the PhD prepares students to become professors or university-level researchers. The PhD's academic focus is reflected in its curriculum, which favors research coursework over clinical topics.
Purpose of the degree
It all depends on which type of doctoral program you're considering, which in turn depends on your past experience and future career goals.
Students without professional experience opt for the entry-level doctorate to shore up their future credentials should the profession's requirements change. Or, they may already have an area of focus in mind and opt for this degree to begin specializing while simultaneously acquiring generalist skills and knowledge.
Licensed clinicians turn to a post-professional doctoral degree program to delve into an area of expertise, brush up on the latest research methodologies, and develop leadership and administrative skills needed for clinical practice management.
Lastly, prospective PhD candidates bound for university-level professorships and research require this degree to advance their academic careers.
All three types of doctoral-level programs require a bachelor's degree in a related field, but they also carry unique admissions requirements:
- Entry-level OTD programs may require GRE scores.
- The post-professional doctorate requires a master's degree in occupational therapy, licensure, and significant experience (several years) as a practicing clinician.
- PhD doctoral programs require an OT master's degree as well and usually stipulate that a minimum master's GPA to ensure candidates can tackle rigorous research academics.
Given how distinct the three distinct doctoral degree programs are, it's no surprise their curricula diverge, too.
Since the PhD track prepares seasoned clinicians to shift into an academic role, its coursework aptly favors research-related topics over clinical courses. Typical classes include biostatistics, research design, grant writing, measurement theory, and models of practice.
Entry-level OTDs prepare generalists entering the field. While they offer some opportunities to delve into specialization, their coursework usually looks more like the MOT curriculum. Everyone sitting for the certification exam and gaining licensure, whether they have an MOT or entry-level OTD, needs foundational courses such as biomechanics, anatomy, neurobehavioral science, aging and developmental theories, the principles of assessment, and evidence appraisal.
Post-professional doctoral curricula vary the most. Their students already have generalist credentials. They aim instead to deep-dive into specializations, learn advanced practice-management skills and get up-to-date on research methodologies.
For example, the coursework required at the University of Pittsburgh's online post-professional Doctor of Clinical Science in Occupational Therapy program assumes students have mastered the basic principles and practices of occupational therapy in hand. Its curriculum includes courses in:
- Advances Assessment
- Advocacy for Implementation
- Conceptualizing and Assessing Quality Improvement
- Evidence Analysis and Synthesis
- Evidence-Based Practice Guidelines
- Evidence of Interpretation for Implementation
- Foundations in Implementation
- Implementation Evidence
- The Business of Implementation
- Theories of Change
Will a doctorate someday be required to practice occupational therapy?
Predicting the future is risky, and in this case, reviewing the controversy's recent history is perhaps more instructive.
In 2018, the OT accrediting council (ACOTE) mandated that all master's degree programs in occupational therapy transition to doctoral degree programs by 2027.
That position kicked off a year of debate between ACOTE and its umbrella professional organization, AOTA. Ultimately, AOTA exercised authority over educational changes.
In 2019, AOTA voted to maintain a dual point of entry into the field and reverse the mandate. That means entry-level clinical positions are still open to those with either a master's or a doctoral-level degree.
Will that change? It's hard to say. If it does, general wisdom suggests licensed OTs with master's degrees will be grandfathered in with their existing credentials. It's unlikely they would be required to go back to school. The concern is perception; if standards shift to a single point of entry at the doctoral level, some OTs worry their MOT degrees may seem inadequate to peers or colleagues from other disciplines.
Occupational therapy master's vs. doctorate: does it matter which I get?
This is a thorny question, with little hard evidence indicating a correct answer. Your career goals are the most significant factor in determining which degree will serve you best.
There's currently no discernible earnings differential between entry-level clinicians with master's degrees versus doctorates. AOTA itself acknowledges that an entry-level doctoral degree doesn't guarantee a higher paycheck.
If your goal is to be a generalized clinician, you could soon out-earn competitors with entry-level OTDs by collecting more certifications and experience. That approach would put you in good stead should you later decide to pursue a post-professional doctorate, a degree that undeniably opens doors to more lucrative administrative jobs.
Going straight into research? An entry-level doctorate may provide a quicker start than the traditional masters-to-PhD trajectory. Similarly, if you already have a specialization in mind, the entry-level OTD's additional fieldwork could distinguish you in certain hiring instances from generalist candidates with MOTs.
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